MEDICARE: MS. RENEE A. SAKATA BHS, COTA/L, CLT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	OTA-2890	NV

General Provider Information

NPI Number	:	1598279069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RENEE A. SAKATA BHS, COTA/L, CLT

Provider Business Mailing Address
First Line	:	1017 S CIMARRON RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-2447
Country	:	US
Telephone Number	:	808-265-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1017 S CIMARRON RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-2447
Country	:	US
Telephone Number	:	808-265-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2017
Last Update Date	:	09/04/2024

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